Determinants of Hypertensive Disorders of Pregnancy in Rural Women in Central India: A Community-Based Cohort Study.

Objective: This prospective cohort study was planned to elucidate the magnitude and epidemiological determinants for hypertensive disease in pregnancy (HDP) in a cohort of rural women of central India. Methods: It was a community-based prospective cohort study of rural pregnant women. 1650 eligible women were recruited at less than 20 weeks of gestation by pretrained field workers in 100 villages of Wardha District. Baseline socio-demographic factors of all subjects were recorded with the help of open-ended pre-designed and tested questionnaire. They were screened for high risk factors. The woman was followed up till delivery for development of hypertensive disorder of pregnancy. Result: The overall incidence of hypertensive disorders in pregnancy was 7.15%. On univariate analysis, significant determinants of HDP were education, occupation, socio-economic status, interval from previous pregnancy, BMI, calcium intake, stress, and family history of hypertension. Odds of HDP increased by 1.075 times with every additional year of age (95%CI: 1.001 to 1.154), by 1.165 times if BMI increases by one unit (95%CI: 1.165 to 1.168), by 1.168 times if stress score increases by one (95%CI: 1.091 to 1.252), and reduced by 0.736 if haemoglobin increases by one gm/dl (95%CI: 0.632 to 0.858). Family history of hypertension doubles the odds of HDP (95%CI: 1.075 to 3.813). Conclusions: This study helped us to know the burden and various epidemiological determinants of hypertensive disorders. It helped us in identifying the modifiable high risk factors that stakeholders should give due attention to formulate preventive strategies for improving obstetric outcome. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-024-02027-y.